Learning clinical procedures through Internet visual resources: a qualitative study amongst undergraduate students

What is important to medical students' online learning of dental trauma in medical education

Traumatic dental injury (TDI), a topic not normally offered in the medical curriculum is made available through the medical school as an online learning course. Online learning provides an educational pathway for cross-disciplinary learning without any change to the existing curriculum. This research identified important key features that should be included in the design of an online course to provide a positive online learning experience for medical students. Ten important features were identified for medical educators to consider when they develop an online course to introduce dental trauma. These features are (1) prioritising information to TDI, (2) providing specific facts and information to TDI, (3) information must be easily retrieved, (4) providing career-related information, (5) promoting self-confidence, (6) promoting learning of new knowledge, (7) easy-to-understand content materials, (8) establishing a logical sequence of learning, (9) visual illustrations to complement written text and (10) promoting self-directed learning.

A novel scale to measure students' perceptions of exemplars in a dental school

INTRODUCTION

Exemplars are an effective strategy for initial cognitive and psychomotor skill acquisition and promoting students' self-regulation. Yet, there is limited evidence about students' use and perception of exemplars in dental education. Therefore, this study aimed to develop a scale to measure students' perception of exemplars in an Australian dental school.

MATERIALS AND METHODS

Phase I assessed the relevant literature and students' responses to an interview. Four themes were identified for developing a 19-item questionnaire rated by an expert panel. Phase II piloted the questionnaire amongst a group of 30 students. Phase III analysed psychometric and qualitative open-ended questions data obtained from a large group of students.

RESULTS

The principal axis factoring resulted in one single factor that explained over 62% of the variance and had an alpha of .88. The number of questions was reduced from 19 to 6 items with loadings of 0.72 or above for each item. Students reported exemplars are beneficial for their learning and to visually guide them to understand procedures and their intended outcomes. This prompts them to think and mentally prepare before performing. Students further reported using exemplars provided by their courses almost as often as exemplars they search in social media.

CONCLUSION

Well-developed exemplars could play a key role in enhancing learning and could assist teaching. Understanding students' use and perception of exemplars will help educators to develop and evaluate appealing exemplars. Therefore, this study developed a new instrument to measure students' perception of exemplars, verified its reliability and validity.

Distance learning course improves primary care dentists' diagnosis and self-efficacy in the management of oral lesions

Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

A microanalysis of expert-student dialogue videos: Supporting preparation and learning for clinical competence assessment

INTRODUCTION

The aim of this qualitative study was to analyse students' perceptions and impact of using a novel video genre designed to support their learning and preparation for a clinical competence assessment. The videos demonstrate expert-student dialogue (ESD) of authentic, one-on-one discourse between the teacher and student, relating to the case presentation and self-evaluation of the assessment.

METHODS

Students who were about to perform a competence assessment were invited to participate in the study. Students were asked to watch a relevant ESD video they had not previously had access to, which showed the examiner-examinee dialogue relating to a peer's tooth preparation for the competence assessment. Immediately after watching the video, a video simulated recall approach was performed to analyse students' perceptions. Thematic analysis was performed to induce relevant themes.

RESULTS

Five themes were identified: analysis and judgement, observational learning from expert dialogue, observational learning from student dialogue, self-efficacy and empathy. Positive responses from interviews suggested high cognitive engagement with this video genre with an affective component that was also valued as an informative learning resource. Students reported the video could stimulate them to think, make it easier to remember knowledge, avoid errors observed, and gain insights into assessment process and examiner's expectations. Empathy was also reported towards the examinee in the video.

CONCLUSIONS

The ESD videos facilitated students' active and analytical thinking as well as improved their assessment preparedness. This video genre has shown how observing ESD can support students' learning and preparation for a clinical competence assessment.

Medical students' perception of an online dental trauma course in medical education

BACKGROUND

With dental trauma education not commonly offered in medicine programmes, offering an online learning course may fill the knowledge deficiency for medical students. The aim of this study is to evaluate medical students' perceptions of an online dental trauma course.

MATERIAL AND METHODS

This was a cross-sectional questionnaire study conducted among medical students at an Australian University. Exploratory factor analysis was used to identify the underlying factor structure within the items. Cronbach's alpha was employed to estimate the factors' reliability. Confirmatory factor analysis was used to assess construct validity; SPSS v22 and AMOIS v22 were used for data analyses.

RESULTS

Exploratory factor analysis identified two distinct factors: 'visual' and 'content', with excellent reliability for visual (Cronbach's alpha = 0.911) and good reliability for content (Cronbach's alpha = 0.755).

CONCLUSIONS

This research supports the findings that medical students perceived the online dental trauma course to be easily understood for self-learning this topic.

COVID-19 is a challenge for dental education-A commentary

The COVID-19, which appeared to originate in China in December 2019, has spread worldwide pandemically. In this commentary, authors described this new challenge for dental education using the recent literature and experience gained in the Italian University of Catanzaro.

Mixed-methods analysis of videoed expert-student dialogue supporting clinical competence assessments

INTRODUCTION

This mixed methods study evaluates the use and perceptions of a novel video genre of authentic, in-the-moment expert-student dialogue to support student preparation for a summative clinical competence assessment.

METHODS

Expert-student dialogue videos were available on the university learning management system (Moodle) for self-directed access for a fixed prosthodontics course. These comprised 3 categories of video relating to dialogic episodes of previous student's performance relating to a clinical competence assessment. These were as follows: case suitability, case discussion and self-evaluation. Fourteen students who were taking the competence test and had watched the supporting videos were invited for focus group interviews. Twelve students participated in three focus groups within 24 hours of the assessment and the audio recordings were analysed. A thematic analysis was performed using an inductive approach. Video access data were also retrieved and analysed based on when the videos were watched.

RESULTS

Three key themes were identified: assessment preparation, enhanced learning and affordance phenomena. By accessing the videos, students gained insights into the case suitability, assessment process and criteria, and the examiners' expectations. They reported reduced uncertainty and stress, improved confidence and better preparedness for the assessment. Students also reported this video genre stimulated higher-order thinking and provided a broader clinical experience. A diverse array of viewing patterns was observed immediately before the assessment and across the year. For the focus group of students, they watched 65% of all their videos for the prosthodontics course one week before their competency testing periods.

CONCLUSION

The expert-student dialogue videos that captured peers clinical competence tests improved students' assessment literacy, increased their assessment preparedness, reduced stress and enriched their learning.

Development of a Nursing Guideline for Improving Skin Integrity in High-Risk Infants

BACKGROUND

High-risk infants are highly susceptible to skin impairment caused by invasive procedures, radiant warmers, and phototherapy, in addition to their intrinsic vulnerability. This leads to a vicious cycle that aggravates the risk of skin infections. Concerns have been raised that neonatal nurses may lack knowledge regarding feasible guidelines to improve skin integrity of high-risk newborns.

METHOD

A clinical guideline was developed for neonatal skin care practices based on skin physiology, and its educational effects on the knowledge and confidence of neonatal nurses was evaluated. A booklet was developed on skin care practice guidelines divided into topics determined through a nationwide survey.

RESULTS

Using a quasi-experimental design with 46 neonatal nurses, education with this booklet improved nurses' knowledge of skin care practices but not their confidence.

CONCLUSION

These findings highlight the importance of implementing a tailored systematic program rather than a single educational session on skin care in high-risk infants for neonatal nurses. [J Contin Educ Nurs. 2020;51(5):238-244.].

Evaluation of a Distance Education Course Using the 4C-ID Model for Continuing Endodontics Education

Continuing professional development (CPD) is needed in endodontics, and distance learning environments and courses may be preferable for CPD. Instructional designs (IDs) have been reported to strongly influence the educational effectiveness of these courses. Four Component Instructional Design (4C-ID) is an ID found to be effective for distance learning. The aim of this study was to evaluate the effectiveness of a distance learning CPD course on regenerative endodontic procedures (REPs) designed with a 4C-ID model. The study was conducted between April 2017 and March 2018 with volunteers from the 2015-16 graduates of Selçuk University's Faculty of Dentistry in Turkey. Pre- and posttests and skill assessment guide were used for assessment. To determine the participants' satisfaction levels, the Satisfaction Scale for e-Learning Process and an open-ended question were used. Of the 86 graduates invited to participate, 79.1% (n=68) responded they would; but the investigators limited the participants to 30, and the first 30 volunteers who had identified a need for REPs CPD were accepted to the course. Four (0.13%) had to drop out during the course, so data from the 26 who completed it were evaluated. The findings showed the difference between pre- and posttest results was significant (p<0.001). The mean score for psychomotor skills at the end of the course was 99.62±1.96 out of 100. On the satisfaction scale, the mean score for all participants was 138.5 on a scale from 29=lower satisfaction to 145=greater satisfaction with the e-learning process. At the end of the REPs course, the participants' knowledge levels had increased, and they were able to apply REP steps on a model. These results suggest the 4C-ID was effective in this distance education course in REPs.

A qualitative analysis of students' perceptions of videos to support learning in a psychomotor skills course

INTRODUCTION

This qualitative study analysed students' experiences and perceptions about different types of videos in a psychomotor skills course, relating to clinical knowledge and skills and how they benefited learners in and out of the classroom.

METHODS

Subjects were recruited from 4th and 5th year dental undergraduate programme. The recruitment was terminated after 24 students participated since data saturation was reached. A semi-structured interview was conducted with each participating student, digitally recorded and transcribed verbatim. A thematic analysis was performed using an inductive approach to identify key themes.

RESULTS

Four key domains were identified from thematic analysis: functionality and access; learning and understanding; clinical skills preparation and performance and supplementary learning resources. Students perceived videos to be an important and vital learning tool relating to its on-demand access, control of functionality and use for particular needs that is not possible from textbooks or lectures. Video learning materials allows students to clarify knowledge, improve cognitive thinking and enhance revision of theoretical concepts and clinical skills. Two types of video were regarded as particularly useful as students reported being actively and cognitively engaged in the learning content and broadened their clinical experience. In addition, students reported mental preparation of clinical psychomotor skills using their own mental visualisation which enabled them to prepare for the clinical care of their patients.

CONCLUSION

This qualitative research supports the benefits of learning from videos in relation to convenience of access and functionality of the videos. In addition, it shows novel aspects to learning from videos that are more cognitively engaging and in mental preparation of clinical skills prior to patient care.

Perceived barriers to the preservation and improvement of children's oral health among Iranian women: a qualitative study

AIM

To explore perceptions of Iranian mothers regarding barriers to preserving and improving oral health among their children.

METHODS

The present qualitative study was part of a larger sequential exploratory mixed-method study conducted in Tehran, Iran, from April to May 2015. Data were collected via 10 focus group discussions and semi-structured interviews to gain an understanding of the perception held by the mothers of school-aged children about barriers to oral health improvement. Sampling was purposive and was continued until data saturation was reached. The study population consisted of 58 Iranian women who had at least one child in school. Data were analysed using conventional content analysis.

RESULTS

Three key themes of oral health barriers were identified as follows: (1) barriers in the system or at the organisational level, (2) barriers at the provider level, and (3) barriers at the family level. Informants reported cost, lack of full-coverage insurance, low access to dental services, and fear and anxiety as the main barriers.

CONCLUSIONS

The major barriers to oral health care were fear and the cost of dental treatments. These predictors need to be addressed when designing programs to increase access of children to dental services.

Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.

Learning Clinical Procedures Through Internet Digital Objects: Experience of Undergraduate Students Across Clinical Faculties

BACKGROUND

Various digital learning objects (DLOs) are available via the World Wide Web, showing the flow of clinical procedures. It is unclear to what extent these freely accessible Internet DLOs facilitate or hamper students' acquisition of clinical competence.

OBJECTIVE

This study aimed to understand the experience of undergraduate students across clinical disciplines-medicine, dentistry, and nursing-in using openly accessible Internet DLOs, and to investigate the role of Internet DLOs in facilitating their clinical learning.

METHODS

Mid-year and final-year groups were selected from each undergraduate clinical degree program of the University of Hong Kong-Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS), and Bachelor of Nursing (BNurs). All students were invited to complete a questionnaire on their personal and educational backgrounds, and their experiences and views on using Internet DLOs in learning clinical procedures. The questionnaire design was informed by the findings of six focus groups.

RESULTS

Among 439 respondents, 97.5% (428/439) learned a variety of clinical procedures through Internet DLOs. Most nursing students (107/122, 87.7%) learned preventive measures through Internet DLOs, with a lower percentage of medical students (99/215, 46.0%) and dental students (43/96, 45%) having learned them this way (both P<.001). Three-quarters (341/439, 77.7%) of students accessed DLOs through public search engines, whereas 93.2% (409/439) accessed them by watching YouTube videos. Students often shared DLOs with classmates (277/435, 63.7%), but rarely discussed them with teachers (54/436, 12.4%). The accuracy, usefulness, and importance of Internet DLOs were rated as 6.85 (SD 1.48), 7.27 (SD 1.53), and 7.13 (SD 1.72), respectively, out of a high score of 10.

CONCLUSIONS

Self-exploration of DLOs in the unrestricted Internet environment is extremely common among current e-generation learners and was regarded by students across clinical faculties as an important supplement to their formal learning in the planned curriculum. This trend calls for a transformation of the educator's role from dispensing knowledge to guidance and support.

Implementation of internet training on posture reform of computer users in iran

Background and Purpose:

Musculoskeletal disorders are of common problems among computer (PC) users. Training of posture reform plays a significant role in the prevention of the emergence, progression and complications of these diseases. The present research was performed to study the effect of the Internet training on the posture reform of the Internet users working in two Iranian universities including Sistan and Baluchestan University and Islamic Azad University of Zahedan in 2014.

Materials and Method:

This study was a quasi-experimental intervention with control group and conducted in two Iranian universities including Sistan and Baluchestan University and Islamic Azad University of Zahedan. The study was done on 160 PC users in the two groups of intervention (80 people) and control (80 people). Training PowerPoint was sent to the intervention group through the Internet and a post test was given to them after 45 days. Statistical software of SPSS 19 and statistical tests of Kolmogrov, t-test, Fisher Exact test, and correlation coefficient were used for data analysis.

Results:

After the training, the mean scores of knowledge, attitude, performance and self-efficacy in the intervention group were 24.21 ± 1.34, 38.36 ± 2.89, 7.59 ± 1.16, and 45.06 ± 4.11, respectively (P <0.001). The mean scores of knowledge in the intervention group 5.45±2.81 and in the control group 1.20 ± 1.07 showed a significant change. Mean scores of attitude in the intervention group 3.60 ± 3.59 and in the control group 0.48± 1.03 showed a significant change as well. Mean scores of self-efficacy in the intervention group 14.83 ± 4.67 and in the control group 0.88 ± 1.93 indicated a significant change and mean scores of performance in the intervention group 5.28 ± 1.24 and in the control group 0.62 ± 0.73 indicated a significant change (P <0.001).

Discussion:

The results of the study showed that training through the Internet had a significant impact on the posture reform of the PC users. According to the findings observed, there was a significant relationship between the scores of self-efficacy-performance after training. Therefore, based on the findings of the study, it is suggested that Internet training to increase self-efficacy approach in the successive periods can be effective to reform the postures of PC users.